To have concerns about counselling

[navymack]

This isn’t about individuals who I am sure mean well and genuinely want to help. But AIBU to worry that some of the treatments offered, at great personal expenditure, are ineffective or even counter productive in some cases?

The costs are really concerning to me - it seems that a lot of money goes into this with universities offering degrees in counselling and individuals charging anything between £30 and £70 per hour.

I have seen over the years people raise concerns about inappropriate things counsellors say to them, and the fact that it isn’t recommended for those in abusive relationships makes me wonder if in fact it is the solve-all it is often presented as being?

I know that individuals will state counselling was helpful to them, but what specifically is so helpful? Is it just having time and impartiality?

Alma, are you suggesting that if it’s ineffective we just carry on with it because there are no alternatives?

But this is what happens. Vulnerable person hands over £40. Vulnerable person feels no better after six sessions. Vulnerable person is told they haven’t had it for long enough and need to try harder. I really feel some of the tactics used by counsellors and others to get people to go to counselling are no better than the pyramid schemes or cults. ‘Do THIS and it will help.’ It stinks.

Nt at all, I'm genuinely asking what a depressed, angry, abused person should do as an alternative to counselling because I can't think of one!

I hope this link works - it's to a book called 'Essential research findings on counselling' and looks at all the outcome and efficacy research in this field.

It is written by a counselling researcher so biased in that sense, but answers a lot of questions you've been asking. I think they are important questions and I ask them myself regularly. I'm a counsellor with post grad and research qualifications and have had many hours of my own therapy.

https://books.google.co.uk/books/about/EssentialResearchhFindingsinnCounselli.html?id=O0FdBAAAQBAJ&printsec=frontcover&source=kpreaddbutton&rediresc=y

The money only seems so expensive because we are used to having health care free.

I do think this is one of the problems, Alma. Counselling or nothing.

But in fact there are things - free things - that can help. Not cure, and they don’t work for everybody but neither does counselling.

It doesn’t seem expensive, it is expensive.

Fine if it works.

If it doesn’t, should an angry, depressed, abused person keep going?

From my point of view as an oldie counselling was a BIg deal as I was brought up with the Stiff upper lip attitude. So plucking up courage to speak about issues was a huge step. But in our society I think it is still difficult for most people to go for counselling. So just going along proves that you do feel there is something wrong that this might fix.
For younger people regaled by peoples outpourings in blogs books ets, self help books etc it is possibly different and help is available elsewhere.

My concerns are about the industry generally and at the way counselling has been presented as a cure all. How often after a traumatic event are we told ‘counselling has been offered’ with the inference that this will be what helps.*

Yes, it's offered. That doesn't mean it has to be taken or will be helpful for that individual.

The problem is that 2 people with the exact same issue, same counsellor etc may not benefit in the same way. Which is why it's hard to measure.

Again, how do you propose to measure a counsellors effectiveness?

I agree it is expensive. I paid £60 a time. I spent a lot of money seeing that awful, awful woman who was my second counsellor. I was a mug but I felt I was in a desperate situation.

So nota,is the inference that a counsellor’s effectiveness just can’t be measured in any way?

What I do have an issue with is the fact that it costs money without its effectiveness being monitored or tangible in amy real way.

There is actually a lot of research about the effectiveness of counselling, if you want to look!

www.bacp.co.uk/news/2017/18-july-2017-nice-agrees-with-bacp-that-counselling-works-as-a-treatment-for-depression-in-adults/

www.evidence.nhs.uk/Search?ps=30&q=therapeutic+counselling

Just some places to start for you.

The NHS runs from NICE guidelines. To be cost effective they deliver evidence based treatments. They offer counselling because there’s plenty of evidence that, when delivered by a competent counsellor for the right problems, it is effective. Not all the time, nothing is effective all the time. But one of the best current treatments available.

Where are you getting the idea from that its effectiveness is not monitored or tangible? IAPT services monitor the efficacy of the different treatments they deliver very closely so they’re not wasting money on ineffective treatments.

I think just being listened to without your views being dismissed or corrected is a big help. Many people have reasons for not opening up to friends or family about things they are ashamed of . So a 'poor' counsellor can do that and it can make a huge difference imv. I did some support work as a volunteer and it was always the last thing they said as you headed for the door, they'd been unable to say it but then blurt it out in desperation as you are leaving, just listening and empathising helped imv. I wasn't a counsellor.
This is why I am pro counselling. It is definitely not right for everyone. Perhaps it should be made clear to people that they are 'trying' counselling. Not that counselling will fix it.

Lolly because you know as well as I that most people will pay privately, make an arrangement to see a counsellor and then if they think ‘hold on, this isn’t working’ are made to feel it is their fault or the counsellor as an individual.

People don’t seem to question if it might be that it is wrong for some people.

It isn’t like fixing a broken leg. Nonetheless, some measurable outcomes should be evident, I would think.

Studies that assess the efficacy of counselling use certain psychological assessments (self reported) to assess whether counselling is helping or not. Some of those used are the PHQ9 and GAD7, which you can freely access online. In NHS services, people receiving counselling are frequently assessed to check whether the treatment is helping, not helping, or harming.

That’s just an example of measurable outcomes. I get the sense you’ve not done much research and therefore have these opinions through lack of knowledge, which is understandable. Hope you can use some of the information I’ve given as a starting point. If you still feel the same after you’re more aware of the issues you’ve raised then that’s fine, but as you’re so interested and passionate about this topic I reckon you’ll want to make sure you’re not judging it based on incorrect information.

People don’t seem to question if it might be that it is wrong for some people.

Op who is saying this? I have never seen anything that suggests that counselling is for everyone

A problem in establishing quality and effectiveness is that it's an umediated one to one, often over a matter if months, relationship. Perhaps the counsellors supervisor should sit in on a session every six weeks or so just to give his/her overview on practice and progress.

Thanks for the thread btw, I think your tone is making people a bit prickly but it’s a very useful topic to discuss, counselling isn’t a cure all, it’s not for everyone, and unethical therapists (who keep taking money for their services privately while secretly knowing it’s not doing a bit of good) should be identified by their clients.

I personally do prefer the U.K. model where the talking therapies offered on the NHS are time limited and focused, I don’t think it’s in anyone’s interests to have long term never ending therapy, it grows dependency. A good therapist works towards a time where the client no longer needs him or her! And when you’re offering services privately there’s definitely a conflict of interests as you don’t want your income to stop but it might not be best for the client to keep going.

longwayoff to keep up your accreditation it’s mandatory to share recordings of sessions with your supervisor, it’s not every session of course (that’d be impossible, some clients don’t want to be recorded, and at a certain point you have to trust that a qualified professional is doing their job properly!) but it is the best way to check how someone is doing so far.

That's interesting what you say about a pyramid scheme, OP as DH said something similar recently.
He has started having counselling). His counsellor paid to have lots of counselling in training and continues to pay for supervision in order to sell their own services.
That does have a bit of a feeling of a ponzi scheme...

You posted that they state they can help with a range of issues. This is correct. They are not claiming they will 'solve all your problems'

they will state they can help with anything ranging from financial difficulties to sexual libido to addiction to low self esteem
It bothers me that some counsellors seem to tick every possible box and therefore I wonder if their experience in these areas is really nothing more than reading a book or two on the subject. I'd like more counselling but would want a counsellor with direct experience of working with autistic people. Plenty of counsellors say they offer that but I doubt many have actually had clients who have (and know they have) autism.
Counselling can be great with the right person - it's an opportunity to offload in a neutral environment, a chance to work through issues and get a different perspective. But I do feel that there are too many people who think it's an easy source of making money because they think 'anyone can do it'. And yet they're taking money from people who think they're paying for an expert.

You’ve never seen threads on here where someone mentions the slightest bit of emotional distress and are urged to ‘get help / get therapy / get counselling’, pink?

Have a read around and come back when you have.

Lolly my tone is prickly because of the attempts to discredit me. Which have now thankfully stopped.

I do think there needs to be more honesty about it, even if that is just ‘I can refer you to counselling, give it a try, it may not work.’ Not ‘get counselling’ with the inference that it will work.

@LollyPopsApple under which body do you have to provide recordings of sessions with your supervisor?

It has always been my understanding that whatever is brought into supervision remains confidential and is for the benefit of the counsellor? With the exception of safeguarding and triple harm concerns that is

Op yes I have seen that but with respect that's not representative of 'everybody' Mumsnet is a small % of the population. It's really quite ridiculous to claim 'everybody' claims it works when you're talking about a small % of the population.

So you have never seen counselling recommended for children, counselling suggested for traumatic events, counselling for marriage problems? No?